HIT Project Managers Need Visible Support of the CIO

Synopsis: Health IT project managers need to be able to rely on the CIO when it comes to understanding HIT project expectations and governance.

Project management in Health IT can be a lot like herding cats – one of the most difficult jobs in the HIT organization regardless of the project management methodologies that are utilized. Projects need solid governance, and HIT Project Managers (PMs) need to be able to rely on the visible support of the CIO, especially at the start of projects, in order to gain authority, credibility, and create and sustain momentum.

Why are health IT projects so challenging? Health IT projects can be extremely complex, requiring HIT teams that are typically comprised of members from various departments and organizations, including vendors. Some team members may be off site, so that the team does not often have the opportunity to meet face-to-face. The PM, while responsible for managing the project’s adherence to scope, timeline and budget, has no direct control over team members. When a project manager has no inherent organizational authority, focusing on the rules of project governance at the start is the most effective and fair approach to proceeding with a project.

Why is the involvement of the CIO so critical? The CIO must be the one to initially communicate the importance of project governance to the team members in order to lend the seriousness and significance of his office to both the project and the process. Ideally, this governance should be spelled out in a document such as a project charter to be presented by the CIO during the project kick-off. Once the CIO has reviewed and explained the governance structure at this important meeting (whether or not it differs from past projects), the CIO should then publicly delegate the responsibility for adherence to the project manager. This passing-of-the-baton is an important way of demonstrating to the entire project team that the PM is an extension of the CIO, and will be expected to manage according to the documented governance processes.

Often times, projects are governed by rules that bump up against an organization’s culture. For example, the charter may stipulate that project meetings will be held during normal business hours, will start and end on time, and follow Robert’s Rules of Order. But the organization’s culture may be more laissez-faire, with people used to coming and going and doing as they please without adherence to formal structure. In this situation, a project manager would find it extremely difficult to proceed according to plan without the overt backing and support of the CIO and other high-level stakeholders who expect the rules to be upheld. Without this support, project rules won’t be taken seriously, and the project manager will be in a no-win situation that could well lead to the delay or ultimate failure of the project.